tbuckley/cabot-search huggingface dataset:
Website and social media presence for National Cancer Institute Community Oncology Research Program (NCORP) sites.
Authors: Carsten Z Steinmetz, Katie Roberts, Alaina Kennedy, Melyssa Foust, Kamara L. Mertz-Rivera, Amarinthia E. Curtis
Journal: Journal of Clinical Oncology (2023)

e23009 Background: The National Cancer Institute Community Oncology Research program (NCORP) is a network which brings cancer clinical trials and care to patients within their own communities. Currently, NCORP consists of 46 sites throughout the United States which receive grant funding through the NCI. We aim to describe the scope of social media use and NCORP dedicated websites. We also aim to describe the correlation between media usage and funding. Methods: We searched NCORP websites and online search engines to identify the social media presence of different NCORP sites. Facebook, Instagram, LinkedIn, and Twitter were the social media sites chosen. Additionally, we searched for NCORP dedicated websites that were separate and distinct from the host institution. We were able to gather public data outlining the total funding received by each site in a three-year span (2019-2021) using the NIH RePORTER. Data was summarized using descriptive statistics. Results: A total of 15 out of 46 sites were determined to have a social media presence, 11 out of 46 sites had NCORP dedicated websites, and 7 out of 46 had both a social media presence and a dedicated website. The social media sites used for the NCORPs were as follows Facebook 8, Twitter 5, LinkedIn 3, and Instagram 1. The content information within the 11 dedicated websites were as follows clinical trials 9, newsletters 2, and provider information 8. All 11 websites had the NCI watermark badge (100% of NCORP websites). The average three-year funding for NCORP sites utilizing social media was $5,371,610. The average three-year funding for NCORP sites without social media was $4,230,552. The average three-year funding for NCORP sites utilizing dedicated websites was $4,681,708. The average three-year funding for NCORP sites without dedicated websites was 4,584,321. There was no statistical significance between funding and websites or social media accounts. Conclusions: NCORPs have an opportunity to disseminate high quality reliable information about cancer clinical trials that meet the need of patients and clinical care providers. However, NCORP sites are rarely a distinct voice on social media or with dedicated websites. Sites may not have resources for this type of communication or may promote the work of NCORP through the communication channels of the host institution(s). Sites with websites or social media accounts had higher average funding. However, this was not significant. Whether social media and NCORP dedicated websites contribute meaningfully to the work of NCI clinical trials remains to be seen and is beyond the scope of this investigation.
Correlation of patient characteristics and tumor histology in patients (pts) with locally advanced cutaneous squamous cell carcinoma (LACSCC) receiving immune checkpoint inhibitor treatment (ICI): A retrospective analysis.
Authors: Khaoula Ben Haj Frej, Phil Kerr, Campbell Stewart, Upendra P. Hegde
Journal: Journal of Clinical Oncology (2023)

e21553 Background: Cutaneous squamous cell carcinoma (CSCC) arising from epidermal keratinocytes is highly curable with surgery. Functional anti-cancer immunity is protective of CSCC and high mortality due to local or systemic dissemination is seen in pts. with immune deficiency. ICI treatment is a logical FDA approved option that result in improved outcomes in affected pts. We report our experience in LACSCC pts. receiving ICI treatment and describe correlation between pt. characteristics, tumor histology and treatment outcome. Methods: Following Institutional Review Board approval, we did a retrospective analysis of LACSCC pts. receiving ICI therapy at the Neag Cancer Center who received at least one dose of ICI between 2018-2023. Analysis includes pt. demographics, relevant comorbidities, medications, and tumor histology and tumor infiltrating lymphocytes (TILs) of tumors reviewed with dermatopathologist. Results: Between 2018-2023, 12 pts. with LACSCC met the criteria for analysis. Median age 77.5 years (yrs.), (range 65-102), 9 males, 3 females, tumors sites - head and neck region 8 pts., torso 2 pts., legs 2 pts. Relevant past medical history included treatment of prostate cancer 3, chronic lymphocytic Leukemia 1, psoriasis 2 (one received anti TNF treatment), and MGUS, Parkinson’s disease and dementia in 1 each. Majority of pts. had significant smoking history (9/12), lymphopenia in 8 out of 12 pts. Tumors were poorly differentiated in 6 out of 12 pts. Brisk TILs was present in 7 and non-brisk TILs in 5 pts. 3 pts. with brisk TILs achieved complete remission (CR), one very good partial response (VGPR), 1 partial response (PR) and 2 not evaluable for response. Out of 5 pts. with non-brisk TILS, one achieved CR, one achieved VGPR, 1 PR, 1 stable disease (SD), and 1 progressive disease (PD) in a pt. who received anti TNF treatment of psoriasis. 9 patients are alive between 1 week and 50 months after initiation of treatment. 3 pts. died, one of PD, one of bacterial sepsis and one of Covid. Conclusions: High risk LACSCC affected males with smoking histories in the majority. Durable responses following ICI treatment occurred irrespective of age, while resistant disease was noted in 1 pt. with previous anti TNF treatment. Brisk TILs predicted high response rate and durable responses although some pts. with non-brisk TILs also showed favorable outcomes. Association with previous cancer and macular degeneration may reflect underlying immune deficiency. Three pts. developed infection within two weeks of ICI treatment (urinary tract infection, wound infection, Covid). More studies will shed light at factors compounding immune deficiency and safety of this treatment in a high-risk population.
Factors associated with health information technology use in adults recently diagnosed with cancer: NHIS 2012-2017.
Authors: Shanada Monestime, Jialiang Liu, Natasha Brown, Estelamari Rodriguez
Journal: Journal of Clinical Oncology (2023)

e18673 Background: Electronic health information technology (HIT) usage among U.S. adults nearly doubled between 2007 and 2014. HIT utilization has been associated with improvement in health literacy, care coordination, provider access, and quality of care. Despite the positive influence of HIT, disparities regarding its usage exist. Individuals more likely to seek cancer prevention information online are younger, Non-Hispanic White, and highly educated. While individuals diagnosed with cancer are likely to research health information online, limited attention has focused on factors associated with HIT use among adults with cancer. The purpose of this study was to identify sociodemographic, behavioral, and health factors associated with HIT use among adults recently diagnosed with cancer. Methods: A cross-sectional analysis using the National Health Interview Survey (NHIS) 2012-2017 was conducted. Adults diagnosed with cancer within 12 months of taking the survey and reported a response to all five HIT variables (using the internet for health information, scheduling an appointment, using chat rooms for health information, filling a prescription online, and emailing a medical provider) were included (N = 3136). Survey-weighted proportions and 95% confidence intervals (CIs) were estimated for all categorical variables, and survey-weighted means and 95% CIs were estimated for continuous variables. Multiple logistic regression models were used to estimate factors associated with overall and individual HIT use. Results: Among U.S. adults with cancer utilizing HIT (51%), the highest usage was looking up health information online (53.37%) and the lowest usage was seen in using online chat groups to learn about health topics (3.04%). There was a higher prevalence in Non-Hispanic Whites looking up health information on the internet and scheduling an appointment; Asians filling a prescription online; and Non-Hispanic Blacks using online chat groups. For a one-unit increase in the number of non-cancer chronic conditions, the odds of using any HIT decreased by a factor of 0.15; p-value=&lt; 0.0001. After adjusting for covariates, significant factors related to any HIT use were identified in patients that were younger; female; Asian and Non-Hispanic White; and had health insurance, higher education, and higher income. Conclusions: Adults recently diagnosed with cancer are increasingly utilizing the internet to find health information but use varies across subgroups. These data could be utilized to direct future research investigating the influence of certain types of HIT interventions on access to health care.
Genomic comparison of MET exon 14 skipping and MET amplified non-small cell lung cancer.
Authors: Rachel Minne, Natalie Luo, Anne M. Traynor, Minxuan Huang, Luisina De Tullio, Jen Godden, Melissa Conrad Stoppler, Randall J. Kimple, Andrew Baschnagel
Journal: Journal of Clinical Oncology (2023)

8553 Background: In non-small cell lung cancer (NSCLC), the MET tyrosine kinase receptor can be dysregulated by mutations and/or gene amplification. The most common MET mutation is in exon 14 (METex14), leading to impaired receptor degradation and increased MET-mediated signaling causing sustained tumor proliferation. MET amplification also leads to continued MET signaling and oncogenesis and can be a mechanism of resistance to targeted therapy. We sought to compare the genomic landscape of METex14 and high-level MET amplified tumors, both of which can be targeted with tyrosine kinase inhibitors. Methods: We analyzed 18,047 NSCLC tumors (any stage/subtype) sequenced with Tempus xT assay (DNA-seq of 648 genes at 500x coverage, full transcriptome RNA-seq). Tumors were queried for METex14 mutations, high MET amplification (METamp), defined as copy number gain (CNG) ≥10, and other MET mutations (METother). Immuno-oncology (IO) biomarkers were compared across MET-altered and MET wild-type (METwt) groups. The prevalence of somatic gene alterations was compared similarly with the false-discovery rate (FDR) adjustment. Results: A total of 276 (1.53%) METex14, 138 (0.76%) METamp, 27 (0.15%) METother, and 17,606 (97.56%) METwt tumors were identified. Across groups, patients with METex14 were older, more likely to be female, and nonsmokers. METex14 exhibited the lowest tumor mutational burden (TMB) and lowest neoantigen tumor burden (NTB). PD-L1 positivity rates were higher in METex14 tumors compared to METamp and METwt tumors. MET log10 gene expression was highest in METamp. METamp exhibited the lowest proportion of CD4 T cells and the highest proportion of NK cells. Compared to METex14, METamp exhibited increased prevalence of TP53 (83% vs 37%), TFEC (46% vs 1.1%), CFTR (37% vs 1.4%), EGFR (31% vs. 7.6%), WNT2 (11% vs 0.4%), KEAP1 (14% vs 0.7%), and STK11 (8% vs 1.4%), and decreased prevalence of MDM2 (4.3% vs. 14%), and FRS2 (2.9% vs. 12%). Conclusions: In this large population-based analysis of MET-altered NSCLC, METex14 tumors exhibited differences in IO biomarkers and the somatic landscape compared to non-METex14 NSCLC tumors. Variations in immune profiles may affect immunotherapy selection in MET-altered NSCLC and require further exploration. [Table: see text]
Disparities in fertility preservation in rural adolescent and young adult patients with hematologic malignancies.
Authors: Ryan Thomas, Sienna Searles, Juvena Hitt, Amanda Kennedy, Sakshi Jasra
Journal: Journal of Clinical Oncology (2023)

e18764 Background: As survival of patients with hematologic malignancies improves, quality of life (QOL) measures have gained importance. Cancer therapies can have a deleterious impact on fertility in patients of childbearing age. Previous studies have highlighted disparities in access to oncology care in rural patients, with negative effects on health outcomes and QOL. This study aims to explore the impact of rurality on fertility preservation in adult young adult (AYA) population. Methods: The study examined patients with a new diagnosis of acute leukemia or lymphoma, ages 15-39, between 2017-2022 at the University of Vermont Medical Center. These included Acute lymphoblastic leukemia (ALL), Acute myeloid leukemia (AML), Hodgkin’s lymphoma, and Non-Hodgkin’s lymphoma. We identified 145 patients and collected data on demographics, insurance, zip codes, cancer diagnoses and whether referral to fertility preservation was requested. Rurality was determined using United States census data, with Rural-Urban Commuting Area (RUCA) codes 1-3 considered urban, and codes 4-10 being considered rural. Results: Of the 145 patients, majority resided in rural (N = 81 or 56%) as compared to urban areas (N = 64 or 44%). Majority of patient did not receive a referral for discussion of fertility preservation (N = 77 or 53%). Of the patients that were referred, more urban patients received referrals (N = 38 or 56%), compared to rural cancer patients (N = 30 or 44%), and this difference was statistically significant (OR = 2.5, 95% CI 1.2-5.14, p = 0.0074). The type of insurance the patient had impacted referral rates. Patients with private insurances were more likely to receive a referral compared to those who had no insurance or had Medicare/Medicaid, (N = 41 or 60% vs. N = 27 or 40%) and this difference was also statistically significant (OR = 2.13, 95% CI 1.04-4.38, p = 0.0243). Conclusions: We find that rural AYA patients with hematologic malignancies were less likely to receive referral for fertility preservation, compared to their urban counterparts. Patients with private insurances had the highest rates of referrals, while patients with Medicare/Medicaid or no insurance were less likely to be referred. This study highlights disparities in access to fertility preservation in rural cancer patients, with significant potential impact on quality of life.
<i>EGFR</i> assessment using next generation sequencing as a reflex testing on surgically resected non-squamous non-small cell lung carcinoma.
Authors: Samantha Goffinet, Veronique Hofman, Christophe Bontoux, Jonathan Benzaquen, Charlotte Cohen, Charles-Hugo Marquette, Jean-Philippe Berthet, Marius Ilie, Paul Hofman
Journal: Journal of Clinical Oncology (2023)

8539 Background: EGFR status assessment is mandatory in early stage (IB-IIIA) non-squamous non-small cell lung carcinoma (NS-NSCLC), but whether NGS methods should be used as reflex testing for this evaluation in daily practice is controversial. However, co-occuring mutations, notably TP53 mutations, may have an impact on tumor behavior and prognosis, and so, on future adjuvant therapeutic strategies. Methods: EGFR mutations were assessed prospectively using NGS (Oncomine Precision Assay genes panel) in 720 NS-NSCLC surgically resected between January 2021 and September 2022 in a single institution (LPCE, Nice, France). PD-L1 expression was evaluated in all tumors. Disease free survival (DFS) analysis was available in 675/720 (94%) patients. Results: EGFR mutations were detected in 83/720 (11.5%) cases. A common non-compound EGFR mutation (L858R or del19) was observed in 62/83 (75%) cases. 12/83 (14%) and 9/83 (11%) tumors had a rare non-compound and compound EGFR mutations, respectively. 40/83 (48%) has a co-occuring mutation, including a TP53 (30/40; 75%) mutation, mainly in exon 5, 7 or 8. EGFR/TP53 mutated tumors were significantly associated with higher PD-L1 expression compared to EGFR mutated tumors. A significant correlation was noted between worse DFS and the detection of a mutation in EGFR exon 18 mutation, as well as the detection of a co-mutation in TP53 exon 7 and in MET exon 14. Conclusions: Genomic alteration should be systematically evaluated using an NGS reflex testing in surgically resected NS-NSCLC, since future adjuvant therapeutic decision making may consider the presence of compound EGFR mutations as well as co-occuring mutations in other genes, especially in TP53.
Prognostic impact of TP53 mutations in metastatic non-squamous non-small-cell lung cancer.
Authors: Laurent Mathiot, Benoît Nigen, Thomas Goronflot, Sandrine Hiret, Ludovic Doucet, Elvire Pons-Tostivint, Jaafar Bennouna, Marc G. Denis, Guillaume Herbreteau, Judith Raimbourg
Journal: Journal of Clinical Oncology (2023)

e21033 Background: TP53 is the most common mutated gene in lung cancer, with a wide range of different mutations. It is unclear whereas TP53 mutations impact the prognosis of patients treated in first-line for advanced or metastatic non-squamous non-small-cell lung cancer (nsNSCLC). Methods: In this retrospective study, we studied the hypothetical impact of TP53 mutations in patients treated in first-line for advanced or metastatic nsNSCLC on overall survival (OS) and progression-free survival (PFS). Secondary objectives were to explore OS and PFS according to treatment received among the two groups. Results: From January 1, 2018 to May 31, 2021, 222 patients were included, 129 in the mutTP53 groups and 93 in the wtTP53 group. Estimated median follow-up time was 26.4 months (95% CI, 24.5-33.5) for mutTP53 group and 24.2 months (95% CI, 20.3-27.5) for wtTP53 group. Median OS (mOS) was 17.5 months (95% CI, 11.3-21.5) in the mutTP53 and 9.5 months (95% CI, 7.3-13.4) in the wtTP53 group, with a significant difference ( p= 0.039). Median PFS was 6.19 months (95% CI, 5.3-7.39) in the mutTP53 and 3.16 months (95% CI, 2.26-5.23) in the wtTP53 group, with a significant difference ( p= 0.011). In multivariable analysis, after adjusting for confounders, the risk of death over the study period appears to be lower in the mutTP53 group than in the wtTP53 group, although this result is not significant (HR 0.74, 95% CI 0.51-1.07, p= 0.11). In subgroup analysis by treatment received (chemotherapy, immune checkpoint inhibitors (ICI) or combination), only patients in the mutTP53 group treated with ICI had a significant improvement in OS compared to patients in the wtTP53 group. The mOS was 24.7 (95% CI, 20.8-NR) vs 10.6 months (95% CI, 4.5-NR) (HR 0.30, 95% CI 0.14-0.64, p= 0.002) for ICI group, and mOS was 20.5 (95% CI, 8.8-NR) vs 16.8 months (95% CI, 8.1-NR) for combination group (HR 1.73; 95% CI, 0.61-4.91, p= 0.3). Conclusions: TP53 mutations is associated with a better OS and PFS than wtTP53 in patients treated with ICI, but we found no difference for patients treated with chemotherapy or combination of chemotherapy and ICI. WtTP53 patient had a short OS on ICI and improved when ICI is combined with chemotherapy. This study emphasizes the importance of evaluating in prospective study the prognostic and predictive role of TP53 mutations in advanced or metastatic nsNSCLC.
Epidemiology and survival trends of lung carcinoids in the veteran population.
Authors: Javaria Tehzeeb, Fatima Mahmood, Darren Gemoets, Amin Azem, Syed Arzoo Mehdi
Journal: Journal of Clinical Oncology (2023)

e21049 Background: Lung carcinoids (LC) continue to increase in prevalence and existing data shows a female predominance of these tumors, but relevant epidemiologic data for heterogeneous populations is limited. In this study, we describe the epidemiology of LC in the United States (US) Veteran population. Methods: In this retrospective study, we searched Veteran Affairs Cancer Cube Registry (VACCR) for LC cases diagnosed between 2000 and 2017 and their baseline characteristics. Survival rates were analyzed across all baseline characteristics to identify important prognostic factors and results were compared with Surveillance, Epidemiology, and End Results cancer database (SEER). Data was analyzed via chi-square and Fischer exact probability tests (level of significance at &lt; 0.05). Results: We identified 846 LC cases in VACCR (91% males), and 8,851 LC cases in SEER (32% males). Compared to SEER, VACCR data had more black patients (12% vs 8%), less cases with loco-regional disease (56% vs 84% in SEER) and same proportion of lower lobe tumors (40%). The annual incidence rate of LC among all lung cancers in Veterans tripled from 2000 to 2017 (0.3% to 0.9%). No racial disparities in treatment were noted among the Veterans. Male-specific 5-year survival rate was 18% lower in VACCR compared to SEER (61% vs 79%). Univariate analysis of both databases showed a statistically significant association of survival with age, primary tumor site and gender (p &lt; 0.05 for all) (Table 1), with advanced age, upper lobe LC and male gender associated with worse survival. SEER subgroup analyses also showed lower 5-year survival rates for males across all baseline characteristics. Overall, black race appeared to be associated with worse prognosis, but the results did not reach statistical significance for VACCR data. Conclusions: Our study showed that US Veteran population, consisting of older males with more comorbidities, LC have lower survival rates than SEER population with more female LC cases. Advanced age, upper lobe predominant disease, and advanced stage were associated with worse survival. Both SEER and VACCR data suggest that male sex is a poor prognostic factor for LC. [Table: see text]
Electronic patient-reported outcomes in a cohort of patients with lung cancer treated in the community with shorter versus longer course PD1/PDL1 therapy.
Authors: Michael A. Kolodziej, Lavi Kwiatkowsky, Patrick M. Travis, Sibel Blau, Sejal Kuthiala, Bijoy Pankaj Telivala, Geoffrey Calkins, Christina Parrinello
Journal: Journal of Clinical Oncology (2023)

e18810 Background: PD1/PDL1 (IO) therapy has been extensively studied as monotherapy and in combination with other IO therapy, chemotherapy and targeted agents. The side effect profile in the clinical trial setting in lung cancer has been extensively cataloged. However, patient-reported symptoms in the real world have not been evaluated and may help inform reasons for patient discontinuation of therapy or adverse clinical events. Methods: Patients from 3 community oncology practices were eligible for inclusion in the study if they had a primary diagnosis of lung cancer, started IO therapy (either monotherapy or in combination with chemotherapy) between Sep 2020 and June 2022 (with follow-up through Dec 31, 2022), and submitted at least 2 ePRO reports during treatment. We examined ePRO reports submitted by patients using a proprietary commercially available ePRO tool. Reports were categorized as high risk if they exceeded a clinical threshold for severity defined by the practices. We also examined the reporting profile by therapy type, and further stratified by time on treatments ( &lt; 6 versus 6+ months of therapy). Results: There were 172 patients included in the analysis. Over this time frame, 68 patients received IO monotherapy and 104 received IO plus chemotherapy. Of these patients, 51% were male and 64% were 65+ years of age. Overall, 68 patients received less than 6 months of therapy and 104 patients received more than 6 months of therapy. There were 3159 reports submitted (1087 within the first 60 days of treatment) with a median of 13 reports per patient. Patients receiving IO plus chemotherapy reported more severe symptoms (symptom severity of 3 or greater on a 5-point scale) within the first 60 days of treatment than those receiving IO monotherapy (51% vs 34%, p = 0.03, Chi square). Regardless of treatment type, patients receiving &lt; 6 months of therapy were more likely to report severe symptoms during this time period as compared to those on treatment for 6 months or longer (Table). 50% of reports triggered an alert based on severity, 22% led to a phone call and 1.3% an emergent office visit. Conclusions: ePROs can identify common side effects in lung cancer patients receiving IO monotherapy and IO/chemotherapy combinations. Early symptoms may define a population at high risk of early discontinuation. Aggressively managing these patients might result in a longer duration of therapy and better clinical outcome. [Table: see text]